Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Traditional Chinese Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Asian J Surg. 2021 Apr;44(4):629-635. doi: 10.1016/j.asjsur.2020.11.016. Epub 2021 Feb 12.
There are conflicting reports on the outcomes of patients with metabolic liver disease after liver transplantation. We aimed to compare the outcomes of living donor liver transplantation (LDLT) for metabolic disease vs orthotopic liver transplantation (OLT) from deceased donation.
Clinical data of 89 patients undergoing liver transplantation for the treatment of metabolic disorders were reviewed. Pre- and peri-transplant demographics, survival rate, complications and laboratory test data were collected and analyzed.
For the 89 patients, only 2 died by the end of the last follow-up. The post-transplant EAD rate and severe complications were higher for OLT than LDLT. No significant difference was found between LDLT and OLT for the incidence of EBV and CMV infections. In terms of laboratory indexes, the recovery time of PLT, AKP and AST levels were significantly longer for OLT than LDLT. Among different types of metabolic disease, no significant difference was found in viral infection, EAD, laboratory indexes, severe complications or duration of hospital stay.
LDLT shows a lower incidence rate of EAD and complications, while it also shows a 1-year survival rate and incidence of viral infections compared similar to that of OLT. LDLT is the better treatment option of pediatric liver transplantation for metabolic liver disease compared with OLT.
代谢性肝病患者肝移植术后结局的报道结果不一。本研究旨在比较活体肝移植（LDLT）与尸体供肝来源的经典原位肝移植（OLT）治疗代谢性疾病的效果。
回顾性分析 89 例行肝移植治疗代谢性疾病患者的临床资料。收集并分析患者术前和围手术期的人口统计学数据、生存率、并发症和实验室检查结果。
89 例患者中，仅 2 例在末次随访时死亡。OLT 的术后急性排斥反应（EAD）发生率和严重并发症发生率高于 LDLT。LDLT 和 OLT 之间 EBV 和 CMV 感染的发生率无显著差异。在实验室指标方面，OLT 的血小板（PLT）、碱性磷酸酶（AKP）和天冬氨酸氨基转移酶（AST）水平的恢复时间明显长于 LDLT。不同类型代谢性疾病之间，病毒感染、EAD、实验室指标、严重并发症或住院时间无显著差异。
LDLT 术后 EAD 及并发症的发生率较低，1 年生存率及病毒感染发生率与 OLT 相似。与 OLT 相比，LDLT 是治疗儿童代谢性肝病的更好选择。
